This project develops and implements technical cost reduction procedures for community hospitals. Earlier work by this group has indicated that certain systems are central to success. These systems provide: 1) an adequate, but not excessive inpatient bed supply; 2) scheduling for a majority of elective patients, with high occupancy and appropriate provision for emergencies; 3) preadmision testing and scheduling of diagnostic and therapeutic services to reduce length of stay. The first two systems are complete and are entering extended application in numerous Michigan sites. Evaluation and improvement are continuing concurrently. The third area is in implementation. One study has shown substantial methodological problems in identifying length of stay reductions, and variation in performance. There is significant reduction of stay in certain cases, however. Bed need determination methods are based on empirical patient service area determination, normative selection of patient day use rates (except obstetrics), and empirical justification of occupancy (from admission scheduling system and simulation models). Application is under way on a statewide basis. Admission scheduling includes simulation model for establishing policy decisions, a game for teaching operators. The schedule policies are manually implemented. An online moel is under study. Cost control in Hospitals is in press (Health Administration Press, Ann Arbor, January 1976). It covers work through 1975. Contract principal investigator for current information.